抄録
The pulley system, a tendoligamentous sling, consisted of the coracohumeral ligament, the superior glenohumeral ligament, fibers of the supraspinatus tendon (SSP), and fibers of the subscapularis tendon (SSC). The most important function of the pulley system was stabilization of the long head of the biceps tendon (LHB) in its intraarticular course. Lesions of the pulley led to instability of the LHB and anterior pain of the shoulder. We reported on two cases of pulley lesions. [Case 1] A 51 year-old man had a pain in the left shoulder when he held his son in his arm. As the pain persisted, he was referred to our hospitals 2 years later. He had a limited motion of the left shoulder in abduction and flexion compared with the unaffected side. MRI showed partial - thickness SSC tear. On arthroscopy, SSC and SSP tears, and fraying of the LHB were found. The LHB was impinged between the superior labrum and the SSP in abduction. After debridement of the fraying and rotator interval closure, the impingement disappeared. The JOA score improved from 79 points preoperatively to 100 points postoperatively. [Case 2] A 51 year-old man had a pain and catching in his left shoulder after playing golf. MRIs revealed SSC tear and anterior subluxation of the LHB. On arthroscopy, SSC tear, fraying of the LHB, and anterior subluxation of the LHB were found. After rotator cuff repair, the subluxation of the LHB disappeared. The JOA score improved from 73 points preoperatively to 98 points postoperatively. Pulley lesion caused anterior shoulder pain.
